Vital Documents

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Death Certificate, Frank Mierzwa

Registration District No. 581, File No. 45005, Registered No. 38
1. Place of death: 705 Dundaff St, 3rd Ward, Dickson City, Lakcawanna County
2. Full Name: Frank Mierzwa
3. Sex: M
4. Color or Race: W
5. Single, Married, Widowed or Divorced: Married
6. Date of borth: Oct 16, 1870
7. Age: 47 years, 5 months, 22 days
8. Occupation: Slate picker in coal breaker
9. Birthplace: Austria
10. Name of father: Tadeuz (sp?) Mierzwa
11. Birthplace of father: Austria
12. Maiden name of mother: Mary ?
13. Birthplace of mother: Austria
14. Informant: Annie Mierzwa, Priceburg, PA
15. Filed Apr 7, 1917
16. Date of daeth: April 6, 1917
17. I hereby certify that I attended deceased from Jan 6, 1917 to April 6, 1917, that I last saw him alive on April 6, 1917 and that death occurred on the date stated above at 4 am. The cause of death was as follows: chronic myocarditis & nephritis, duration 1 to 2 years
18. (blank)
19. Place of burial or removal: St. Mary's, Priceburg, PA; date of burial: April 8, 1917

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